MSK Interest Survey


	ARDMS Registered in Musculoskeletal Sonography (RMSK) Credential Information Interest Page

* = required fields
ARDMS # (if applicable):
*First Name:
*Last Name:
*Gender:
*Address Line 1:
Address Line 2:
Address Line 3:
*City:
*Country:

*State:

*Zip Code:

*E-mail Address:
Phone:


Are you interested in participating in the ARDMS MSK Pilot Examination for the RMSK credential which will be available in early 2012?	YesNo
Do you currently hold an ARDMS credential (RDMS, RDCS, RVT, RPVI)? YesNo
What is your current profession?	Physician (MD/DO) Sonographer Radiographer Physician Assistant Nurse Practitioner Registered Nurse (RN) Other (Please specify)
In your practice what is your primary specialty area of expertise?	Elbow Wrist & Hand Hip Knee Ankle & Foot Other (Please specify)
What MSK Societies do you belong to or know of? (if applicable)
What MSK journals do you subscribe to or read? (if applicable)
What MSK websites do you frequently visit? (if applicable)

By providing your contact information, you are authorizing ARDMS to send you communications (ie. e-mails and/or physical mail) that relate to the subject of MSK ultrasound and the design and implementation of an MSK credential through the ARDMS. As always, ARDMS is committed to protecting your personal information and will not share your e-mail address or phone number.

Physician Specialty

	Please select your specialty:
	Rheumatologist Chiropractor Radiologist Orthopedist Osteopathy Podiatrist Other (Please specify)

Current Credentials

	Please indicate your current ARDMS credentials: RDMS RDCS RVT RPVI